目的：分析交通事故死亡伤员的法医尸检报告，探究主要致死性损伤，为今后交通事故危重伤员的急救提供指导。方法收集德阳市2009年1月~2012年8月432例现场死亡或经院外急救、院内抢救无效死亡，死亡后由法医尸检的交通事故死亡伤员的尸检报告；回顾性分析交通事故死亡伤员的尸检报告、直接致死性损伤及其致死率，来判定交通事故死亡伤员的主要致死性损伤。结果单纯颅脑损伤致死率为68.98%；多发伤致死率为25.47%；单纯性胸内脏器损伤、腹内脏器损伤、骨盆骨折、颈椎损伤、四肢骨折、烧伤窒息共六类损伤致死率共5.55%。颅脑损伤致死率与多发伤致死率之间，以及分别同其他六类单纯性损伤致死率之间的差异性经u检验，差异有显著性统计学意义。结论交通事故死亡伤员最主要的致死性损伤是颅脑损伤，多发伤位居第二，其他六类单纯性损伤致死所占百分较低，为非主要致死性损伤。交通事故伤员院外急救培训工作重点是颅脑损伤、多发性损伤的急救，失血性休克的抢救治疗。%Objective To analyze the death autopsy report of traffic accidents, explore the causes to death, and furnish valuable reference for providing efficient emergency service to those critical injured in traffic accidents. Methods 432 death cases which occurred in Deyang either in the scene or in hospitals in between January, 2009 and August, 2012 were collected and analyzed. Results It reflected 68.98% of them traumatic brain injury, 25.47%of multiple injury, 5.55%of simple thoracic viscera injury, abdominal injuries, fractures of the pelvis, limbs fracture, cervical spine injury, and burns. It also demonstrated significant differences in the U test between traumatic brain injuries and other six kinds of simple injury death. Conclusion Traumatic brain injury is rated no. 1 to cause death in traffic accident death, multiple injuries is the second followed by the six other types of single injury. The causes request an intention in first aid training focusing on traumatic brain injury, multiple injuries, and hemorrhagic shock.
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